Angular Cheilitis

Angular Cheilitis is a condition in which one or both corners of the mouth develop cracks and sensitive sores and eventually get infected. The ends of the lips become dry, scaly and painful. The infection is caused by continuous exposure to the bacteria present in the saliva. The bacteria get accumulated in the cracks of the lips giving rise to infection. The infection may be caused by various microbes like bacteria, virus or fungi leading to Oral Thrush or candidiasis.

Causes

• Vitamin deficiency, particularly of B12
  
• Exposure to irritants
  
• Drooling of saliva in children
  
• Poorly fitted dentures
  
• Weakened immune system
  
• Systemic disorders
  
• Dry weather
  
• Continuous licking of lips
  
• Loss of teeth in elders

Signs and Symptoms

Initially, angular cheilitis will show up with mild symptoms, and if left untreated, turns chronic and causes severe discomfort. At the initial stage, Angular Cheilitis presents itself with the following symptoms:

• Tight feeling near the angles of the mouth
  
• Dry and scaly lips
  
• Mild discomfort in opening the mouth.

As the condition worsens one may suffer from the following symptoms:

• Redness with pain
  
• Sores and bleeding fissures
  
• Pain and oozing
  
• Difficulty while talking and eating.

Angular Cheilitis causes

A single definitive cause is yet to be ascertained. Contributory factors are identified. Poor nutrition and infection score high as compared to other factors. One or combination of these factors is enough for bacteria or fungus in the mouth region to suddenly multiply and cause localized soreness.

• Nutritional deficiency of mineral and vitamin (folate, iron, B-vitamin deficiency)
  
  
• Deficient immune system
  
  
• Poor hygiene
  
  
• Diabetes, cancer, anemia, Celiac disease, HIV/AIDS, infection
  
  
• Ill fitting dentures , dry mouth, tobacco smoking, make-up, lip balm, high fever, cold weather, allergic reactions, overdose of vitamin A
  
  
• Facial disorders where the lips are enlarged, Down syndrome, Crohn's disease
  
  
• Medications to treat specific health issues such as lithium (for mania), ionized (TB), D-penicillamine (Wilson's disease), retinoids for acne, chemotherapy agents, phenothiazine (for headache, mental disorders).

Angular Cheilitis signs and symptoms

• Slight tightness in one or both corners of the mouth causing discomfort in opening mouth.
  
  
• Formation of small flaky skin in the corners of the mouth.
  
  
• Redness and swelling that tempt frequent licking of the mouth which aggravate the condition.
  
  
• Split corners at the edges of the mouth.
  
  
• Difficulty in eating and talking.

Treatment

Treatment for angular cheilitis involves applying topical anti bacterial and anti fungi creams or ointments along with oral medication. Ointment with emollient properties is usually prescribed and depending upon the microbial infection antibiotics, antifungal, anti-viral and topical steroids are prescribed.

Angular cheilitis can also be treated at home with the help of easily available natural products. Aloe Vera, honey or fresh neem leaves have anti bacterial and anti fungi properties. They can be gently rubbed on the wounded area at frequent intervals. Applying salt water on affected region works well as the saline water inhibits the growth of bacteria and kills the existing microbes.

Appearance of Angular Cheilitis is often misconstrued to be an outcome of cold sore throat. It is actually a form of dermatitis, a type of skin infection. Typically, one or both the corners of the mouth have lesions making opening of the mouth highly painful. If left untreated, the lips can chap and the areas around the lips may start to peel off thereby worsening the condition.

A culture test to establish the bacteria, fungus or virus is required. A swab from the affected corner is taken and tested. Nutritional supplements containing Vitamin B12, folate and iron are suggested. Maintain good oral hygiene and avoid lip makeup till the condition improves.